Coronary calcium scoring: are the results comparable to computed tomography coronary angiography for screening coronary artery disease in a South Asian population?

Abstract

BackgroundThe need of having feasible screening tools like Coronary Calcium Scoring (CCS) and CT Coronary Artery (CTCA) for Coronary Artery Disease (CAD) has become paramount. We aimed to evaluate the accuracy of CCS in determining the degree of stenosis of coronary vessels as compared to that determined by CTCA in a South Asian population.MethodsA retrospective study was conducted at The Aga Khan University Hospital. A total of 539 patient records were reviewed who had undergone CCS and CTCA between 2008 and 2010. Patient records were reviewed by comparing their CCS and CTCA results.ResultsAbout 268 out of 301 (89%) patients with a CCS of 0–9 were found to be free of stenosis on CTCA. On a CCS of 10–99, 110 out of 121 (91%) patients were either free of stenosis or had mild stenosis. About 66 out of 79 (84%) patients had moderate or severe stenosis with a calcium score of 100–400 while none of the patients were free of stenosis. Around 28 out of 38 (74%) patients with a CCS of more than 400 had severe stenosis. However, only 04 patients (11%) were found to have mild stenosis. Spearman’s rho revealed a correlation coefficient of 0.791 with a p-value of <0.001.ConclusionOur study reaffirms that in South Asian population, low CCS (<100) is associated with no or minimal stenosis while high CCS warrants further investigation; hence, making it a reliable tool for screening patients with CAD.

Statin eligibility and cardiovascular risk burden assessed by coronary artery calcium score: Comparing the two guidelines in a large Korean cohort

“…Thirdly, there are few studies that CACS is useful for re-stratification for cardiovascular events in Asian population. However, there are some studies performed in Asian population regarding the predictive value of high CACS for cardiovascular mortality compared to low CACS, providing the evidence of CACS as the reliable tool for screening in Asians [35,36]. Fourth, our study has another limitation that we do not have the follow up data for these study population.…”

Angiographic coronary artery disease and high-sensitivity troponin-T in a native Pakistani cohort presenting with chronic chest pain

“…This study was conducted before coronary artery calcium score measurement became routine and used a semi‐quantitative measure of CAD atheroma burden (Gensini score) that shows a weak correlation ( r = 0.30) with coronary calcium scores . However, in general calcium scores correlate with severity of atheromatous disease measured on CT coronary angiography in Pakistani populations suggesting that this relationship is still relevant to modern practice.…”

Bioimaging and Subclinical Cardiovascular Disease in Low- and Middle-Income Countries

“…[46,47] One report from a large urban teaching hospital in Pakistan examined the correlation between CAC scores and coronary luminal obstruction based on CT angiography. [47] Consistent with findings from cohorts in high-income countries, the authors found that low CAC scores (< 10) were associated with a low frequency of obstructive CAD while a majority of subjects (74%) with CAC scores exceeding 400 had severe coronary stenosis. [48] Another study from India found that presence of CAC in an asymptomatic population was associated with traditional atherosclerotic risk factors, such as age, hypertension and diabetes mellitus.…”